Individual
DR. DANIELLE MARIE CICCONE- COUTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
419 CENTER ST STE C, GRAYSLAKE, IL 60030-1645
(262) 412-7302
Mailing address
11314 E RIVIERA DR, SPRING GROVE, IL 60081-8146
(262) 412-7302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009251
IL
Other
Enumeration date
03/11/2016
Last updated
04/26/2018
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